Etessam, Ali
Etessam, Ali is an sole proprietor health care provider with primary practice located at 3 Corporate Park Ste 165 , Irvine CA 92606-5161. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Etessam, Ali can be contacted via phone (949) 207-7377.Contact Information
Primary practice address
3 Corporate Park Ste 165
Irvine CA 92606-5161
Phone: (949) 207-7377
Fax: (949) 207-3227
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | PT20329 | California |
Profile Details
| NPI number | 1558403733 |
|---|---|
| LBN Legal business name | Etessam, Ali |
| Credentials | D.P.T. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 13th, 2007 |
| Last updated | Sep 16th, 2021 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1558403733 | NPPES |
| California | MEDICAID | PT0203290 |
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